Identification of severe acute malnutrition requiring inpatient care in children 6–59 months of age

In children who are 6–59 months of age, severe acute malnutrition is defined by a very low weight-for-height/weight-for-length, or clinical signs of bilateral pitting oedema, or a very low mid-upper arm circumference. Severe acute malnutrition affects an estimated 19 million children under 5 years of age worldwide and is estimated to account for approximately 400,000 child deaths each year.

While requiring nutritional intervention, not all severely malnourished children require hospitalization. With the development of ready-to-use therapeutic foods, treatment of severe acute malnutrition in children 6 – 59 months of age without medical complications and with good appetite is increasingly provided on an outpatient basis.

Inpatient treatment of severely malnourished children can be costly and disruptive to families in settings with limited resources. Minimizing unnecessary hospitalization while ensuring that those children requiring inpatient treatment get the care they need represents the best use of resources. This can be achieved in part by establishing admission and discharge criteria based on careful consideration of medical condition.